151 -Strengths Based Approach to Treating PTSDCounselor Toolbox

Objectives – Highlight the functional nature of most behaviors and reactions – Define PTSD – Examine the function and meaning of PTSD symptoms – Develop an understanding of why some people develop PTSD and others do not – Explore useful interventions for persons with PTSD

Reward and Survival – Humans and animals experience reactions to prompt behavior – Anger/Fight – Fear/Flight – Reactions are responses designed to – Protect life – Achieve a reward/avoid punishment PTSD and Gradual Onset PTSD – PTSD: Traditional exposure to an event or multiple events – Military – Crime Victims – Gradual Onset PTSD: repeated exposure to horrific or threatening events causing a sense of helplessness – Law Enforcement – Military – Child Abuse/Neglect Definition – Exposure to a horrifying event in which there was a sense of helplessness – For each symptom that follows, we will identify – The function – What triggers that symptom or exacerbates it – How the person deals with/mitigates that symptom – Other things he or she could do Symptoms – Re-experiencing the traumatic event – Intrusive, upsetting memories of the event – Flashbacks (acting/feeling like the event is happening again) – Nightmares – Feelings of intense distress when reminded – Intense physical (panic) reactions to reminders Symptoms – PTSD symptoms of avoidance and emotional numbing – Avoiding reminders of the trauma – Inability to remember important aspects of the trauma – Loss of interest in activities and life in general – Feeling detached from others or emotionally numb – Sense of a limited future Symptoms – PTSD symptoms of increased arousal – Difficulty falling or staying asleep – Irritability or outbursts of anger – Difficulty concentrating – Hypervigilance (on constant “red alert”) – Feeling jumpy and easily startled

Triage – Similarity to the victim (or being the victim) – Proximity to your safe zones (home, work) – Social support after the trauma – History of mental health problems – Number of stressors in the past 6 months

Assessment – If you were not the victim, how were you similar to the victim- – How are people around you similar to the perpetrators- – What was (or would have been) helpful for people to do after the trauma- – Who can you rely on to do those things now- Creating Safety – What can you do to take back your “safe zones” – How can your protect yourself from this in the future- – How did the experience change – How you view things- – What is important to you- – How you will live your life now-

Cognitive Processing Therapy – Some beliefs about safety, happiness, or people/situations in general can be distorted by trauma. Ask yourself: – What happened- – What is the belief- – Is this belief based on facts or feelings- – How reliable is the source- – Are you using extreme words- – Is the belief based on only part of the picture- – In what ways does this belief protect you- – In what ways does this belief impair your life- – How can you best use your energy-

Cognitive Errors – Overgeneralization – Control fallacy – You could have controlled it – You can change it (If I would have…) – All-or-Nothing Thinking – Catastrophizing – Grandiosity – Personalization

Stress Management Can’t squeeze blood from a turnip

– Emotional Health – Physical health – Exercise – Nutrition – Sleep – Socialization Trauma Recovery – A grief process – Loss of control – Loss of a sense of safety – Loss of hope – Loss of idealism – Loss of ___________________________ – Grief Stages – Denial – Anger – Bargaining – Depression – Acceptance Grief Resolution – What losses did you experience as a result of the trauma – For each loss: – What about this makes you angry- – How can you deal with this anger healthfully- – Anger protects you and pushes people away. What do you still need to be protected from- – Depression signals a sense of hopelessness or helplessness. About what can you be hopeful- Empowered- Summary – PTSD can be from a single event or multiple, ongoing stressors – Traumatic Events can change people’s beliefs about the world in an extreme way – For some people understanding the function of the symptoms can help them – Desensitize – Modify their beliefs – Make positive, mindful choices

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